Call 12: Health-care stories draw interest

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By Robert AnglenThe Republic | azcentral.comSat Dec 7, 2013 7:34 PM

When Phoenix resident Eric Victor needed cancer surgery, he turned to Mayo Clinic Hospital. Everything went well until he got the bill from his insurance company.

Anthem Blue Cross Blue Shield wanted him to pay $2,300 for his private room at the hospital, which isn’t covered under his plan. The only problem: Mayo Clinic has only private rooms.

Nearly two years after his 2011 surgery, Victor was still fighting the insurance company. In 2012, the company rejected his appeal, saying he didn’t file it in a timely manner, even though his policy gave him 15 months to file a dispute. In frustration, Victor turned to Call 12 for Action.

Victor’s case reflects a growing frustration among consumers over health-care costs and insurance. Throughout November, Call 12 for Action focused on cases involving people who were denied coverage, billed for services they didn’t request or whose existing insurance plans soon could put livesaving medication out of their price range.

The stories sparked widespread interest, drawing phone calls and e-mails from readers and viewers who sought help with similar issues. Three cases profiled in November resulted in $182,820 in savings for consumers who sought help.

And the number of Call 12 for Action cases likely will grow under the Affordable Care Act, according to veteran Call 12 volunteer Steve Sandler. “People who have insurance are confused. People who have never had to deal with insurance are going to be more confused. Culture shock,” Sandler said. “Obamacare is giving more people who didn’t have insurance access to it. It is not an easy trip.”

Call 12 also documented problems with cost calculators tied to the Affordable Care Act, showing how some online sites spit out inaccurate costs based on flawed estimates. The story about online calculators generated national interest.

It was referenced in a health-care blog, which repeated the advice of insurance specialists regarding shopping for health plans under mandates requiring most Americans to get insurance by 2014: Consumers shouldn’t let prices from online calculators discourage them from enrolling.

But it was stories of personal problems that resonated most with our audience. The case of a Scottsdale lawyer who was transported to a hospital unconscious and woke up 12 days later facing a $150,000 bill prompted quick response from readers and viewers.

“It's despicable that the insurance companies and the hospitals don't take the time to negotiate for the patients,” Tina Gomez-Bennett said in an online comment. “It's more despicable that they can get away with charging so darn much money and then negotiate it after countless encounters with whoever, the media, etc. ... and then decide that the patient didn't have to pay it after all.”

The lawyer, Bill Richardson, credited Call 12 with helping resolve the dispute with his insurance company, which wanted him to pay $120,000 because he used an out-of-network hospital. He said Call 12 helped to get the hospital and the insurance company to negotiate and erase $118,000 of the charges.

Another case involved an Arizona City woman who said she was transported against her will via an AirEvac Services helicopter, which billed her $32,700 for the 20-minute flight. Lawyers said state laws make it a crime to force patients to receive treatment against their will. They said the case could result in civil and criminal charges against the company.

AirEvac Services agreed to dismiss the bill after the case was made public, saying it offers patients reductions under low-income assistance programs. The patient in the case, Laura Karr, said it would not have happened without Call 12.

Online posts about the story drew a lot of interest from people across the country.

“Yes, flight services do pressure their crews to take patients so they can send out a bill,” Gary Vogel said, in an online comment. “Yes, they could legally let her go if she signed a release from liability.”

Andrew Tucker, who works in the medical field, said in an online post that he would never call a helicopter unless it involved a trauma case.

“One rule that my partner and I used was that if a patient is able to remember the helicopter ride, they probably don't need one,” he said.

Not every case ended satisfactorily for those involved. Robert Johnson, who suffers from a rare life-threatening immune-deficiency disease, sought help after he was informed this medication would cost him $3,000 a month under changes in his Medicare drug plan coverage.

Johnson receives about $1,600 a month through Social Security disability. His insurer, Abrazo Health Care, promised to work with Johnson and last week enrolled him in a policy that will cost him about $3,400 in the first two months and then $39 per month the rest of the year.

Johnson said he was angry about the $3,400 charge, which he said he can’t afford. He said he will be forced to borrow money from his brother. He said the changes in Medicare affect people who can least afford it and that legislators and insurers seem unconcerned about their plight.

“I am really disgusted ... about the way I was treated by the insurance company,” Johnson said last week. “I am mad at the world. I got screwed in this deal.”

In Victor’s case involving the private room at Mayo, the insurer agreed to drop the $2,300 charge. The company ultimately dropped its claim that he failed to file his dispute on time.

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